The URL can be used to link to this page

14090171 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 1479 POPPY WAY CON RACTOR:T PERMIT NO: 14090171 ra 'air OWNER'S NAME: MANISHA VADHIA DATE ISSUED:09/25/2014 OWN S PHONE: 4082423639 PHONE NO: LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL �j DEMO&FILL(E)SWIMMING POOL&SPA.FILL FOR License Class /� Lic.# LANDSCAPE PURPOSES ONLY Contractor Pot 1; .G-I y, Date f -S 1 I hereby affirm thaf I am licensed under the provisio of Ch pter 9 (commencing with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force an&effect. I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self-insure for Worker's Compensation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$4000 I have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this APN Number:36615025 00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct.I agree to comply with all city and county ordinances and state laws relating WITIIIN 180 DAYS OF PERMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save 180 D LLIED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the ZS Date: granting of this permit. Additionally,the applicant understands and will c with all non-point source regulations per the Cupertino Municipal Code,Section 918. RE-ROOFS: Signatur l _,,�� Date y All roofs shall be inspected prior to any roofing material being installed.If a roof is installed without first obtaining an inspection,I agree to remove all new materials for inspection. ❑ OWNER-BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I,as owner of the property,or my employees with wages as their sole compensation, will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) I,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. 1 will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: Health&Safety Code,Section 25532(a)should I store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized aate: permit is issued. I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If,after making this certificate of exemption,I CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C) Lender's Name APPLICANT CERTIFICATION Lender's Address I certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes.(We)agree to save ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional 918. Signature Date CITY OF CUPER TINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 1479 POPPY WAY DATE: 09/25/2014 REVIEWED BY: MELISSA APN: 366 15 025 BP#: "VALUATION: $4,000 xPERMIT TYPE: Demolition Permit PLAN CM,CK /TIT. PRIMARY PENTAMATION USE: Swimming Pool, Res. PERMIT TYPE: 1SFP00LDE WORK DEMO & FILL E SWIMMING POOL& SPA. FILL FOR LANDSCAPE PURPOSES ONLY SCOPE FEE ID #POOLS 1DEMOPRES 1 licc'a Plat Cho 1, 111crn Checi' 1'"in ChCc ti c,,.. llcr ;l Fee: ,i'fumh. 1'c mit keep: f :.. r', 1�ldec°h. hgsn Other Plumb 7rup. E3-L- 0`R";"1 cc h-SI". E3--I- h- htaia F11C Phsrrth,lnspz Ilee t 'c:€.'. i 4}, NOTE: This estimate does not include fees due to other Departments(ue.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc. . These fees are based on the prelimina information available and are only an estimate. Contact the Dept-for addn'1 info. FEE ITEMS (Fee Resolution 11-053 E . 7/1/131 FEE QTY/FEE MISC ITEMS r' bu"' (Vicc r S1'1f)j)1' PC FCC Permit Fee: $329.00 S{upp[l. Ingsp.Fele. Reg. Q OT 0,0 hrs $0.00 l�laln�t� . '(;I��c° (.ons°Iruction Lira, ir'trSt'1`itr'tr�trf 1'c'?'Writ FA �I�i�erts?c<:1I'lrtrrtairr�s1'��es: 1,<!.'s'r/}rl `7,1172c'f?/ldf7ltl'1 Fees: � Strong Motion Fee: IBSEISMICR $0.52 Select an Administrative Item Bldp,Stds Commission Fee: 1BCBSC $1.00 $330.521 $0.00 TOT=AL FEE: $330.52 Revised: 08/20/2014 \ SWIMMING POOL / SPA PERMIT APPLICATIO Q 10 COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 S P (408)777-3228•FAX(408)777-3333•building(Wcupertino.org CUPERTINO PROJECT ADDRESS � J1' yy 4W4 '_!�. G u jo e-r t f, APN# / / O OWNER NAME _( ! W PHONE Q E-MAIL a-h r`s Vad �c. d 2�'fZ3� va h/k h, vM STREET ADDRESS `]cfg`7 �„/Q�/ CITY, STATE,ZIP,('J� ; C f, I FAX CONTACT NAME t _/ PHONE / (E-MAIL STREET ADDRESS t l CITY,STATE,ZIP I t FAX �- ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT !P CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME ��. LICENSE NUMBER LICEN&YPE BUS.LIC# d� COMPANY NAME E-MAIDr h � +FAX e 7�� I STREET ADDRESS CITY STATE, P PHONE /O c�J�/ Ale ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP // PHONE DESCRIPTION OF WORK Yl�yI„p a�A 1 /I7 Pool -CV V- Z-A4,� rG / 'ptdd/Aj USE OF ❑ SFD or Duplex Multi-Family TYPE MATERIAL TYPE(CODE) AREA (SQ.FT.) VALUATION($) STRUCTURE: ❑ Commercial POOL POOUSPA MATERIAL TYPE CODES: SPA J j V - VINYL-LINED r F - FIBERGLASS DEMO G - GUNITE i I4 P - PREFABRICATED �. '" a y }} V LUATION: By my signature below,I certify to each of the foil pr wne author' agent to act on the property owner's behalf. I have read this application and the information I have provided is correct. I have read the D I ork and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to buildin construction. I an 'ze representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL TION REQUIRED �� -,OFFICE usEQ Y ) CHECK T'S;PE _ ROUTING SLIP _Commercial or Multi-Family Buildings with Public Swimming Pools: Department of Environmental Health approval required. �U Eo�ER THE COI7RTER ❑;BJII DING WEPT O EXPRESS ❑ I ANNING DEPT �❑ STANDKRD r ❑ IIBLICWORKS DEPT i BARE- ❑ J&VIRON51ENTALREALTH �ItiR rotJ - ❑ SANITARYSEWERDLSTRICT SwimPoolApp_2011.doc revised 03/16/11 B � Cupp o building Depa ent GREVIEWED FOR CODE COMPLIANCE Reviewed By. co, -1016 s b h fa'ho o �,f ora �Sf2sA®e; eY y OOg°ff h /oGfaoaf�Oo er h/ Ar 10, p �o� foo0aa4o `sr�c`9�SfGas;/anG/f`6o, ,o� 'o, 10 °o/ 010'a a� Aof da�f` /odCEIVE *21 e SIP 2 5 2014 r Ufa of;°,�o�► Va'dti`A �� Ih pal 4�, 20 i3 G1)6 6,0 es t